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Sick Day or Not? How to Determine if Your Child Needs to Stay Home from School

Edited by Dr. Sheila Abdallah
Department of Family Practice

When you have a sick child, deciding whether or not to keep them out of school or daycare is a difficult decision – and one you have probably struggled with many times. Keeping your child home often means that one parent or guardian has to miss work to stay home as well.  Plus, no parent wants their child to miss out on learning and school activities that their child enjoys.

So how do you decide? Use the following information as your guide:

Fever.  A fever usually indicates a contagious illness. A child with a fever of 100.4 Fahrenheit or higher should stay home, to prevent spreading their illness to classmates and teachers. Most schools want your child to be fever-free for 24 hours (without fever-reducing medication) before returning to class. How your child appears and behaves is also important. If they appear sick and not feeling well, it’s a good idea to keep them home and see how they feel the next day.

Vomiting or Diarrhea. If your child is vomiting or having diarrhea, these symptoms should be managed at home. Monitor your child carefully and introduce food and drink slowly. Try the “BRAT” diet, which consists of bananas, rice, applesauce and toast, which is easy on a child’s stomach. If keeping down food is difficult, try frequent small sips of electrolyte-containing fluids to prevent dehydration. Contact your healthcare provider if the vomiting or diarrhea lasts more than 24 hours or is accompanied by a fever or signs of dehydration. Some “stomach bugs” such as the Norovirus are quite contagious and have been known to cause large outbreaks in schools. For that reason, it’s important to wait 24 hours or longer after symptoms have resolved before your child returns to class.

Sore throat. Sore throat can have several different causes. COVID-19, strep, allergies, or the common cold are all possibilities. If the cause of a sore throat is allergies or a mild cold, and your child has no fever and feels well enough to be in class, it’s probably fine to send them to school. If you suspect your child has something more severe like strep throat, they should stay home from school and see a healthcare provider for testing. Strep throat comes on suddenly and is usually accompanied by a stomachache, fever, or headache. It usually doesn’t cause cold-like symptoms like a cough or runny nose.  Please do remember that sore throat can be caused by COVID-19, so any sore throat should prompt home testing for COVID prior to sending your child to school.

Coughing, sneezing and runny noses. Keep in mind that COVID-19 symptoms are quite broad, and can include coughing, sneezing and a runny nose. A home antigen test can determine whether your child has COVID-19 or a different illness. It’s important to keep your child out of school and follow all guidelines if they test positive for COVID-19. Children with a mild cough and some cold symptoms who test negative for COVID often can go to school, as long as they feel well enough to be in class. You should remind them to wash their hands often and cough into their elbow to help protect their classmates. If their symptoms are severe, for example, if they have a fever or if their breathing sounds or appears different than usual, they should stay home from school and be seen by a healthcare provider. Contact your doctor’s office for advice if you need help determining what to do.

All parents want their child to be comfortable in school and ready to learn, while also not exposing others to potential illness. Use the guidance above and your best judgement to decide whether to send your child off to school if they are not feeling 100%.

Sick Day or Not? How to Determine if Your Child Needs to Stay Home from School

About Sheila Abdallah, MD

Dr. Sheila Abdallah went to medical school a little later than most people, when she was 36 years old. “I was interested in healing the whole person, and when I graduated from college in the 1990s medicine seemed very fragmented to me, she explains. “So, I did hospice work and then human rights work overseas for a number of years. After that, I felt I wanted to do something that helped physically heal people…and I realized I was ready...

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